Medical students should learn about disorders of the nervous system (DNS) because they are common. These disorders (whether of brain, spinal cord, peripheral nervous system or muscle) account for up to one in eight consultations in general practice, one in five emergency medical hospital admissions and a high proportion of disability (particularly severe and progressive disability) in the population. Disorders of the nervous system are relevant not only to the clinical specialities of neurology and neurosurgery but also, inter alia, to psychiatry, general medicine, general practice, anaesthetics, radiology, pathology and clinical pharmacology.
We recommend that students should have sufficient understanding of basic neurosciences to support learning about disorders of the nervous system (DNS) and the principles of their diagnosis and management.
We recommend that students should take the full range of opportunities presented in a medical curriculum to learn about DNS.A multidisciplinary approach to learning should be encouraged and learning should be broadly linked to patient experiences, clinically relevant events and opportunities guided by appropriate neurologically trained staff.
We recommend that the newly qualified doctor should have the skills to:
- recognise what clinical events may indicate DNS
- obtain, report and interpret an accurate history relating to DNS
- carry out, report and interpret an appropriate neurological examination including that of the unconscious patient
- formulate a differential diagnosis and implement appropriate monitoring, observation and early treatment in emergency situations
- understand the nature of and indications (and contraindications) for common neurological investigations and the significance of important results
- understand the key roles of other medical specialities and the multidisciplinary team in the management of DNS.
We recommend that the newly qualified doctor should have knowledge of:
- basic neuroscience to support understanding of clinical practice and to provide opportunities to expand learning and research
- major neurological symptoms
- common and/or important neurological conditions and their management
- common emergency problems and their management
- common investigations and their role
- principles underlying management of neurological disability including an understanding of the relationship between impairments, activity and participation
We recommend that each medical school has an implementation strategy for learning about DNS with a clear clinical lead (usually though not exclusively from Clinical Neurology) to highlight and coordinate local learning opportunities in collaboration with other specialties and basic neuroscience disciplines.
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